NPI | 1871751180 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: MA 277293) |
Additional Taxonomies | 208600000X Surgery (Licence: VA 0101242673) |
Enumeration Date | 2008-05-23 |
Last Update Date | 2019-01-29 |